More should be done to counter an ''unfortunate'' series
of public health problems, including New Zealand's unusually
high rheumatic heart disease death toll, University of Otago
Prof Robin Gauld says.
About 180 New Zealanders die every year from the disease,
which a Ministry of Health report says has been ''virtually
eradicated'' from most developed countries. The disease is
often linked with poverty, including rural poverty in parts
of the North Island's east coast. University of Otago
researchers have recently highlighted several major public
health problems, including New Zealand's internationally high
obesity rate - which, at 27%, is behind only the United
States (33%) and Mexico, according to 2007 figures.
A report by an independent task force on workplace health and
safety has also taken issue with our internationally high
rate of workplace deaths and injuries.
It is about twice as dangerous to work in New Zealand as in
Australia, and nearly four times as risky as working in
New Zealand also has one of the world's highest rates of
melanoma, and internationally high rates of colorectal cancer
and youth suicide.
Prof Gauld, who directs the university's Centre for Health
Systems, said the rheumatic heart disease deaths were ''not a
A key problem was it was hard to clarify exactly where the
country's health system was performing well and badly, and
more cross-sector learning was needed.
This country should adopt the approach taken in the
Netherlands, where an independent group produced a
comprehensive healthcare performance report every two years.
With 20 district health boards, New Zealand effectively had
at least 20 different health systems, and some disease rates
and health outcomes also varied throughout the country.
Some district health boards already had a ''strong focus'' on
There was also scope for some boards, including the Southern
DHB, to take a more ''system-wide'' approach to public
health, and to include general practitioners more fully at
senior management level.
The Government had - ''not without good reason'' - been
focusing on improving hospital efficiency, given some
hospitals were ''hugely inefficient'', although individual
clinicians were performing well.
But public health had become, to some extent, the ''poor
cousin''and more Government funding and effort were needed to
meet public health challenges, he said. Prof Gauld is the
first author of a recently-published research paper, which
gave this country its first ''scorecard'' for health system
A 71 out of 100 rating was gained, but several problems were
identified - including cost barriers to adult primary care
and dental care.